Initial Assessment clarification

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oranjour

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A practice exam I am studying poses the following question:

"When palpating the pulse during the initial assessment, which of the following would not be assessed at this point?"

The correct answer the study guide provides is: "The exact heart rate".

Yet, just 3 questions later the study guide asks:

"You arrive on the scene of an auto crash and find a patient who appears to be extremely cyanotic to his face and neck. During your initial assessment, you note a respiratory rate of 42 breaths per minute and a shallow depth, a strong radial pulse of 92 beats per minute, normal capillary refill, and skin that is slightly pale, cool, and cyanotic. You would suspect this patient is most likely suffering from:"

The last question seems to contradict the first and suggests that you should get an exact pulse rate during the initial assessment. Which is the best practice?
 
The initial assessment is to give you a broad picture of the patient. Breathing fast or slow? Breathing adequate or not? HR fast or slow? HR regular or irregualr? Pt sick or not sick?

The give your more exact info in the scenario just so you're able to answer the question.




Think about when you first walk up to a patient and place your hand on their wrist... do you sit there for any length of time counting, or do you continue your questioning while feeling for an adequate (or not) pulse?
 
Linuss said:
Think about when you first walk up to a patient and place your hand on their wrist... do you sit there for any length of time counting, or do you continue your questioning while feeling for an adequate (or not) pulse?
Click to expand...

Depends on the situation, but to be honest, if you've taken the time to feel for a pulse, what's 15-30 seconds to get a number? I honestly don't think I've ever just 'felt for a pulse' without seeking a number.
 
If anything about the 'initial assessment' is off, it gets scrutinized further.


If their HR is regular and seems in a good range, I'm content for the time being.






I can't count and ask questions at the same time :P
 
oranjour said:
A practice exam I am studying poses the following question:

"When palpating the pulse during the initial assessment, which of the following would not be assessed at this point?"

The correct answer the study guide provides is: "The exact heart rate".

Yet, just 3 questions later the study guide asks:

"You arrive on the scene of an auto crash and find a patient who appears to be extremely cyanotic to his face and neck. During your initial assessment, you note a respiratory rate of 42 breaths per minute and a shallow depth, a strong radial pulse of 92 beats per minute, normal capillary refill, and skin that is slightly pale, cool, and cyanotic. You would suspect this patient is most likely suffering from:"

The last question seems to contradict the first and suggests that you should get an exact pulse rate during the initial assessment. Which is the best practice?
Click to expand...

Your reading into NR questions. Don't, you will fail. Take them completely at face value.
 
oranjour said:
A practice exam I am studying poses the following question:

"When palpating the pulse during the initial assessment, which of the following would not be assessed at this point?"

The correct answer the study guide provides is: "The exact heart rate".

Yet, just 3 questions later the study guide asks:

"You arrive on the scene of an auto crash and find a patient who appears to be extremely cyanotic to his face and neck. During your initial assessment, you note a respiratory rate of 42 breaths per minute and a shallow depth, a strong radial pulse of 92 beats per minute, normal capillary refill, and skin that is slightly pale, cool, and cyanotic. You would suspect this patient is most likely suffering from:"

The last question seems to contradict the first and suggests that you should get an exact pulse rate during the initial assessment. Which is the best practice?
Click to expand...

The exact HR would be obtained later in the exam. Initially I just want to make sure they have a pulse and find out the quality.
 
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